肾母细胞瘤VEGF及其受体Flk-1的表达及其临床意义

Expression of vascular endothelial growth factor （VEGF） and its receptor （Flk-1） in nephroblastoma

目的 探讨肾母细胞瘤组织中血管内皮生长因子（VEGF）及其受体（Flk-1）的表达和肿瘤微血管密度（MVD）的临床意义.方法 应用免疫组织化学（SABC）法检测33例肾母细胞瘤、瘤旁组织和6例正常肾组织中VEGF、Flk-1表达和MVD计数.观察并分析三个指标之间的相关性,同时分析其临床意义.结果 33例肿瘤组织VEGF阳性表达率81.8%,Flk-1阳性表达率69.7%,瘤旁组织VEGF阳性表达率9.1%,Flk-1阳性表达率6.1%,6例正常肾组织VEGF及Flk-1均为阴性表达,三者之间差异具有统计学意义.肿瘤组织MVD值29.7±12.4,瘤旁组织MVD值10.3±9.6,正常肾组织MVD值9.8±2.3.肿瘤组织的血管密度与后二者比较差异具有统计学意义.VEGF表达与Flk-1、MVD计数正相关,Flk-1与MVD表达正相关,VEGF、Flk-1表达在不同临床分期,及转归之间均具有显著性差异.结论 肾母细胞瘤中VEGF及其受体Flk-1呈高表达,血管生成增多,VEGF、Flk-1表达与MVD密切相关,提示VEGF及其受体Flk-1参与肾母细胞瘤的血管形成过程,促进血管生成,与预后相关.

Objective To investigate the expression and clinical significance of vascular endothelial growth factor （VEGF） and its receptor Flk-1 in nephroblastoma. To assess whether tumor microvessel density （MVD） immunoreactivity, determined by the CD34 antigen, is related to the expression of VEGF and Flt-1. Methods Immunohistochemical staining （SABC） was used to examine MVD and the expression of VEGF, Flk-1 in 33 nephroblastoma tissues, 33 paracancer renal tissues and 6 normal kidney tissues. The relation between the expressions of VEGF, Flk-1 and MVD was analyzed in different clinical stage and pathology type, Patients were treated preoperatively with chemotherapy and mean follow up was 34 months. Results The positive rates of VEGF and Flk-1 in nephroblastoma tissues were 81.8% and 69.7%, the positive rates of VEGF and Flk-1 in paracancer renal tissues were 9.1% and 6.1%, the expressions of VEGF and Flk-1 were negative in all normal kidney. The differences between the three groups were statistically significant （P＜0.05）. In nephroblastoma tissues,the expression of VEGF correlated to both Flt-1 and MVD （P＜0.05）, and the expression of Flt-1 correlated to MVD （P＜0.05）. In addition, the expressions of VEGF and Flk-1 were increased in clinical stage Ⅲ and poor prognosis. Conclusions These results indicate that VEGF and Flk-1 may play an important role in nephroblastoma angiogenesis. Increased expression of VEGF and Flk-1 in nephroblastoma correlated with tumor stage, clinical progression and tumor related death. VEGF and Flk-1 protein expression are closely related to MVD and seem to be a important predictor for poor prognosis in treated patients with nephroblastoma.